Summary: One-fifth of the US population is living with chronic pain, and some of them with high impact chronic pain. A new study shows that poorly managed chronic pain is a leading cause of faster cognitive decline, memory loss, and thus increased Alzheimer’s risk. Further investigation found that people with low socioeconomic status were particularly at risk due to healthcare disparities. The study also suggests that these health disparities may partially explain the higher prevalence of Alzheimer’s in black Americans. Hence, the study highlights the need for equal access to chronic pain treatment for various population groups.
Almost half of all adults may experience prolonged episodes of pain in their lifetime. However, data suggests that 20% of the population in the US continues to live with chronic pain at any given time, and these are massive numbers. Even worse, 8% of adults have high-impact chronic pain, and most have to live with it due to poor pain management.
Chronic pain is distressing, to say the least. However, in recent years, doctors have started to realize that chronic pain is also responsible for an increased risk of many chronic health disorders. For example, those living with poorly managed chronic pain are more likely to develop high blood pressure, heart disorders, depression, sleep disorders, and more.
Now the new study suggests that chronic pain may be a risk factor for cognitive decline. This finding is especially relevant, considering the rise of dementia. Dementia is now among the leading causes of premature death and disability, affecting millions of lives.
The new study was published in the Journal of Alzheimer’s Disease. The study carried out detailed check-ups of 147 adults between the ages of 45 and 85. Researchers focused particularly on sociodemographic information and cognitive assessment and used MRI brain scans.
They found that pain increased dementia risk, particularly in those with low education levels, low income, and thus with poor access to healthcare. In addition, they found that compared to those with better socioeconomic and education status, these individuals demonstrated 4% less gray matter. Thus, these findings were not merely subjective and were supported by objective data.
Of course, losing gray matter with aging is a common phenomenon. Early studies show that people gradually start losing gray matter as they age. This process generally begins in the 50s or 60s in different individuals. Generally, this decline is about half a percent each year. Thus, 3-4 percent equates to 6 to 8 years. It means that the brain of socially and economically deprived individuals age much faster.
However, what is worrisome is that most people are diagnosed with conditions like Alzheimer’s in their 50s or later. This reduced grey matter in socially deprived individuals also suggests that they are at a greater risk of developing Alzheimer’s.
Researchers have also been focusing on how various stressors may contribute to an increased Alzheimer’s risk. For example, they found that the risk of developing dementia is almost twice as high in blacks compared to whites.
Hence, this study found that this difference is not explained solely by genetics or ethnicity. Instead, it seems that health disparities are also an important contributing factor. These kinds of disparities lead to higher pain and stress exposure and thus resulting in faster brain aging, memory issues, and a greater risk of Alzheimer’s in blacks compared to whites.
Moreover, the study also suggests a relationship between pain intensity and brain aging. It appears that the risk of faster brain aging is proportionate to the pain intensity. It means that those with poorly managed chronic pain are more likely to develop dementia.
This is not the first study. An early study that was done in 2017 also had similar kind of findings. It found that those older than 60 and living with chronic pain were more likely to see a sharp decline in their cognitive abilities.
However, there is some good news for those living with poorly treated chronic pain. A study in 2009 found that treating chronic pain well may even help reverse some of the changes in the brain. All these findings highlight the importance of managing chronic pain and providing sufficient relief.
By Gurpreet Singh Padda, MD, MBA